Active NPI
Marguerite Ann Kelly, LICSW
- Social Worker
- Northampton, MA
National Provider Identifier
1578533832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 1019735
- Practice address
- 94 King St
Northampton, MA 01060-3284 - Phone
- (413) 695-7084
- NPI assigned
- Jan 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 1019735 | MA | Primary |
Addresses
Primary practice location
94 King St
Northampton, MA 01060-3284
Mailing address
34 Harold St
Florence, MA 01062-1030
Phone (413) 695-7084
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P06037 | Other | MA | BCBSMA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070130000009 | MA | Practitioner - Clinical Social Worker | 1456352715 | Practice locations: Florence, MA; Northampton, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
34 Harold St
Florence, MA 01062-1030
Phone (413) 695-7084
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1019735 | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578533832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 HAROLD ST",
"city": "FLORENCE",
"state": "MA",
"postal_code": "010621030",
"telephone_number": "413-695-7084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94 KING ST",
"city": "NORTHAMPTON",
"state": "MA",
"postal_code": "010603284",
"telephone_number": "413-695-7084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MARGUERITE",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "1019735",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSMA",
"identifier": "P06037",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Northampton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.